I would add performance and load testing to the list. It isvery important to have the right infrastructure and to make sure that yoursoftware and infrastructure match. By loading testing your application withvirtual users, you can ensure you'll get the right performance before you golive. There are two schools of thought when it comes to automated performancetesting. One looks at the back-enddatabase and network activity to derive the performance. The other looks at time it takes the end-userto perform a task. We believe that trueperformance testing of any healthcare systems should be tested from the enduser perspective and that is why we created our testing suite. Find out more athttp://www.nrgglobal.com/healt...

I completely agree with you with regards to the amount of support we are able to expect towards your gamification of professional medical. I just donG«÷t see many individuals accepting this technique yet. In regards for the other points created here though, I agree these areas certainly are a little under-appreciated as of this moment but I start to see the focus shifting soon once we will probably see in the next HIMSS.http://www.worksure.org

#3 feels like the linchpin for every other predictive trend mentioned here. When hospitals and docs can marry their healthcare delivery expertise with the tech/innovation expertise of software developers -- yes the IBMs of the world, but also smaller/more-nimbler tech shops --- the benefits will be two-fold: 1) better and more intuitive medical technology that can enable better information transfer, patient tracking, performance and data analysis, etc; and 2) faster trickle-down of that technology to smaller and more remote institutions i.e. big hospital sells it to little hospital (and little hospital buys it with greater confidence and speed from a fellow hospital, as opposed to a non-healthcare-expert tech company. Whether or not any of this new profitability from effectively selling software will curb any healthcare costs (short-term) is an entirely different discussion.

Particularly the last three ring true, although if you're not looking in those directions, not sure you understand the immediate future of medical device IT. A few specific comments: point four on Vendor Neutral Archives -- the example given of CT images -- they have actually been in a standardized format since the beginning with header and image information following strict rules, but yes, there was always the temptation to throw in an "improvement" that made the records from particularly a large vendor "more compatible" with the record storage part of the business.

Point three with the Provider / Vendor cooperation would seem to not only be business 101, talk to your customer, but what all regulatory agencies require in development. The interesting part is the financial and management role of the "customer" as opposed to hoping the vendors pay attention to their medical professionals.

Point five is BYOD, and if you think you have problems being a CIO in a non-medical environment with "company secrets" add on absolutely draconian fines for not only divulging patient info, but just not knowing if somebody unauthorized has them or not. Try developing or servicing in that environment. But yes, this is where patient and professional contact is going, and the trick to this segment is privacy -- Interestingly the US puts enforcement of privacy in the hands of a Civil Rights Division to show they're serious.

My take is yes, important trends, but not sure they are a mystery or underrated to a sentient being that develops this stuff.

I completely agree with you in regards to the amount of support we can expect towards the gamification of healthcare. I just donG«÷t see many people accepting this approach yet. In regards to the other points made here though, I agree these areas are a little under-appreciated as of this moment but I see the focus shifting soon as we will probably see in the next HIMSS.

Some of this analytical focus definitely is falling on the patient -- identifying chronic disease patients and trying to get them on disease management programs, studying which type of patients end up back in the hospital and why and trying to head off those problems.

As an example of Drawbaugh's point #3, PatientKeeper recently completed a joint development project with Partners HealthCare: an infusion billing capability that works with PatientKeeper Charge Capture software. (Partners plans to go live with the new infusion billing soon.)

I assume that CIO Dan Drawbaugh is not a doctor or a healthcare provider. It's easy to theorize what can be done, but he ignores the fact of people's health beliefs. Not just culturally, but how people perceive seeing a doctor and getting treatment and expecting a cure. Yes, intelligent, college educated with professional careers people ask me questions like this all the time. For example, with high blood pressure, heart disease, gout,diabetes, and thyroid problems I am asked, "For how long do I have take the medication?" Medical people assume that patients know about chronic disease and the treatment. My answer, "Until there's a cure or a better treatment." During the flu & cold season, I see hundreds of people that want a cure for their cold and won't believe that an antibiotic won't help and there's no cure. They often go to other providers or worse, the Emergency Department, because they can't breath through their nose and don't like coughing.

It's time to stop looking at the health care provider for the cost of medical care and start doing metrics on the consumer of health care. Even when emergency department "super users" were found primary care that they could use, the "habit" of going to the emergency room did not change. This is the population of people that have the health belief of wanting to see a doctor now and do not like the niceties of making an appointment and having to wait a day, even when they have health insurance, transportation, low co-pay, their health belief is getting care 24/7 and playing by their own rules.

Patient surveys should not include questions about days to get appointment, waiting room time, was the staff nice, but the survey should ask what they expect from the encounter with the medical provider, was their expectation met, what they think about their diagnosis, what they feel about taking medications, will they follow the health advice given, will they follow the treatment plan, do they expect a complete healing of their medical problem. That would make for good data and find out what the consumer of health services is thinking and how to make them partners in cutting healthcare costs.

Great to hear right from a CIO of this caliber on this topic. Re point #5, I think there is going to be a lot of pushback from consumers re applying gamification to disease management and healthcare in general. I just don't buy into people liking this approach yet.

As InformationWeek Government readers were busy firming up their fiscal year 2015 budgets, we asked them to rate more than 30 IT initiatives in terms of importance and current leadership focus. No surprise, among more than 30 options, security is No. 1. After that, things get less predictable.